It's the question every Tucsonan has asked since Jan. 8: Accused shooter Jared Lee Loughner showed so many signs of mental illness, but apparently didn't seek help and wasn't forced into treatment.
Only he - and possibly his family - knows why he chose the path he did. But an Arizona Daily Star investigation reveals a system full of hurdles and contradictions that make help elusive for people with mental illness.
State law requires a residential-treatment system for those who need help, but supporters of the law have agreed it won't be enforced this year - and perhaps beyond - because of the state's budget woes.
Money problems also prompted the state to end case-management services and stop providing name-brand drugs to 28,000 lower-income Arizonans who don't qualify for Medicaid. The changes prompted a Sierra Vista woman - no longer able to get the medication that kept her illness at bay - to kill herself.
There are so few psychiatrists in the state that those reaching out for help often can't get an appointment for up to three months.
Arizona lets people petition to force others into mental-health treatment - even if they're not an immediate threat to themselves or others - but the law is largely unknown, difficult to navigate and results in compelling someone to get treatment only about half of the time.
Over all that is a shroud of stigma that only got darker when stories of Loughner's rants and writings - which experts say show signs of a disturbed mind - became public.
Even patients coping well with mental illness worried after the arrest that the public would see them as scary and dangerous. Actually, though, few people with mental illness are violent - and those who are typically hurt only themselves.
Today: Persistent stigma keeps many people from seeking help for mental illness.
Monday: A state law guarantees treatment, but a back-office budget deal means it's not being enforced. And the end of case management and brand-name-drug coverage left many marooned.
Tuesday: Forcing someone into treatment is possible but difficult. And a shortage of psychiatrists in Tucson means that even if you find a doctor who will see you, your first appointment might be months away.
Wednesday: Unless you're living in poverty, your insurance may not cover mental-health treatment.